Respiratory mechanics in patients ventilated for critical lung disease

Research output: Contribution to journalArticle

Abstract

Respiratory mechanics, using flow interruption, was previously studied during the complete breath in healthy ventilated man, numerical techniques relieving constraints regarding flow pattern. The classical linear model of non-Newtonian behaviour was found to be valid. The present study was extended to subjects with critical lung disease. Subjects with acute lung injury (ALI; n = 2), acute respiratory distress syndrome (ARDS; n = 4), and chronic obstructive pulmonary disease (COPD; n = 3) were studied with and without positive end-expiratory pressure (PEEP). Functional residual capacity (FRC) was measured with sulphur hexafluoride (SF6) wash-out. The static pressure-volume (P-V) curve was linear at zero end-expiratory pressure (ZEEP), but nonlinear at PEEP. Its hysteresis was nonsignificant. In ALI/ARDS, PEEP increased lung volume by distension and recruitment, but only by distension in COPD. In ALI/ARDS, resistance was increased, at ZEEP. In COPD, resistance became extremely high during expiration at ZEEP. In ALI/ARDS at ZEEP, non-Newtonian behaviour, representing tissue stress relaxation and pendel-luft, complied with the classical linear model. At PEEP, the non-Newtonian compliance became volume-dependent to an extent correlated to the nonlinearity of the static P-V curve. In COPD, non-Newtonian behaviour was adequately explained only with a model with different inspiratory and expiratory behaviour. The classical model of the respiratory system is valid in ALI/ARDS at ZEEP. More advanced models are needed at PEEP and in COPD.

Details

Authors
Organisations
External organisations
  • Henri Mondor Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Respiratory Medicine and Allergy

Keywords

  • Adult, Aged, Aged, 80 and over, Female, Functional Residual Capacity, Humans, Infant, Newborn, Lung, Lung Diseases, Obstructive, Male, Middle Aged, Positive-Pressure Respiration, Respiration, Artificial, Respiratory Distress Syndrome, Adult, Respiratory Distress Syndrome, Newborn, Respiratory Mechanics, Respiratory Physiological Phenomena, Journal Article, Research Support, Non-U.S. Gov't
Original languageEnglish
Pages (from-to)262-73
Number of pages12
JournalEuropean Respiratory Journal
Volume9
Issue number2
Publication statusPublished - 1996 Feb
Publication categoryResearch
Peer-reviewedYes